The Effect of Simulation-Enhanced Orientation on Graduate Nurses: An Integrative Review

A mixed method approach to substantiate quantitative data with qualitative data: Improving clinical judgment in prelicensure nursing students using simulation

BACKGROUND

Current literature demonstrates a gap in research involving mixed method study of clinical judgment development in prelicensure nursing students.

OBJECTIVES

Clinical judgment of two groups of nursing students were compared using the Lasater Clinical Judgment Rubric (LCJR).

DESIGN

A mixed method convergent parallel quasi-experimental cross-sectional approach was used to determine if simulation increased clinical judgment skills between beginner and advanced pre-licensure nursing students.

SETTING

The research site included nursing labs housing 20 hospital beds and a five-room medical simulation lab.

PARTICIPANTS

Student participants were recruited from the Pacific Northwest. A convenience sample included 128 part-time and full-time beginner fundamental and advanced senior nursing students.

METHODS

t-Test differences were compared between quantitative dependent dichotomous independent variables. Differences in mean scores, standard deviations, and number of data values of each group were analyzed. Qualitative analysis of field notes and post simulation reflection logs occurred alongside quantitative findings.

RESULTS

Quantitative differences in LCJR scoring (Lasater's Clinical Judgment Rubric) were statistically significant (p < .001) using the unpaired t-test as Cohort B (advanced senior) scored higher than Cohort A (beginner fundamental). Qualitative analysis of the 11 LCJR subset data substantiated quantitative scoring through triangulation. Post-simulation reflection logs revealed comparatively similar qualitative responses for both cohort groups as the need for improvement while expressing emotion during simulation was captured.

CONCLUSIONS

Recommendations for educators and administrators include the promotion, design, and execution of simulation across the nursing curriculum by well-trained nursing educators. Formative and summative clinical judgment evaluation will solidify this pedagogical feature in simulation and elsewhere. Simulation is considered a valid pedagogy requiring proper execution for the assimilation of knowledge, skills, and attitudes. Employment of regular clinical judgment assessment and evaluation should occur across the simulation curriculum. Simulation provides a dedicated time and space for nursing students to practice and reflect upon how they will be better prepared in clinical judgment upon graduation prior to entry to practice.

Simulation's Use Across the Clinical Landscape

Across the healthcare continuum simulation is routinely integrated into the curriculum for nurses and other professionals. The amount of simulation experienced at different points in the clinical setting highly depends on the specialty and organizational investment. The use of simulation in nursing can be divided into five specific use cases. Required and specialty certification courses include the following: Nurse Onboarding, Nurse Continuing Education, Regulatory & Joint Commission, and Interprofessional Education. Although common elements exist for each of the abovementioned use cases, there are distinct advantages, disadvantages, and implementation challenges with each that need to be considered.

Construction of a Training Content System for New Nurses in Cancer Hospital Based on Competency

Objective

To construct a training content system for new nurses in cancer hospitals based on postcompetency and to provide guidance for clinical new nurse training.

Methods

Based on literature review, semistructured interviews, and questionnaire surveys, a new draft of the nurse training content system was initially established, and 17 experts were selected to make two rounds of inquiry on the system by the Delphi method, so as to construct a new nurse training content system.

Results

The effective rate of recovery of the two rounds of expert correspondence was 100%, the cooperation among experts was high, and the authoritative coefficient of experts was 0.89. The content system of new nurse training constructed included 2 first-class indexes, 5 second-class indexes, and 45 third-class indexes.

Conclusion

The new nurse training content system is closely combined with clinical work, pays attention to improving nurses' competence, reflects the characteristics of nursing work in cancer hospitals, has a certain scientific and practical significance, and can provide guidance for the training of new nurses in cancer hospitals.

The Effectiveness of Simulation Use in Transition to Practice Nurse Residency Programs: A Review of Literature From 2009 to 2018

Representatives of three international associations reviewed literature published from 2009 to 2018 to ascertain the effectiveness of simulation use in transition to practice programs for newly licensed registered nurses (NLRNs). A review of nine quantitative studies demonstrated that simulation positively influences NLRN self-perception of skills, competence, readiness for practice, and confidence. However, evidence of objective measures of NLRN competence and the impact of simulation on patient and organizational outcomes was lacking.